| 제목 |
Relationship between NRA Sign, MRI Findings and Clinical Symptoms of Lumbar Spinal stenosis |
| 소속 |
Konkuk University Medical Center and Konkuk University School of Medicine, Department of Rehabilitation Medicine1 |
| 저자 |
In-Sik Lee1†, Seunghwan Lee1* |
Objective
In this study, we investigated the relationship between the Nerve Root Aggregation (NRA) sign and clinical symptoms in patients with Lumbar Spinal Stenosis (LSS). Moreover we identified the correlation between the Proportion of Area of Nerve Root to Dural Sac (PANRDS) and NRS sign.
Methods
This retrospective study involved 19 patients diagnosed with lumbar spinal stenosis at the L4-5. We assessed the NRA sign and measured the PANRDS on T2-weighted axial images of MRI at the lower margin of the disc space just proximal to the level of LSS. In order to evaluate the NRA sign quantitatively, we measured the area of the nerve root and the dural sac divided into right and left and then calculating the ratio. Clinical symptoms included the intensity of lower extremity pain and degree of claudication. The AP diameter of the spinal canal at the most stenotic level was also measured to identify the association with the severity of LSS.
Results
In the positive NRA sign group, the PANRDS was found to be significantly higher than the negative NRA sign group. Also, interval between onset of symptoms and MRI evaluation in the positive NRA sign group was significantly longer than the negative. Diabetes mellitus was more prevalent in the positive NRA sign group, albeit without significance. However, there was no statistically significant association between NRA sign and clinical symptoms of LSS.
Conclusion
The positive NRA sign had a statistically significant relationship with PANRDS and interval between onset of symptoms and MRI evaluation. However, no statistical significance was found between NRA sign and clinical symptoms of LSS.
Keywords
lumbar spinal stenosis, nerve root aggregation sign, Magnetic reasonance imaging, clinical symptoms, proportion of area of nerve root to dural sac |
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Table 1. Characteristics of patients
Table 2. Characteristics of patients according to the NRA sign
Figure 1. T2-weighted axial image of MRI. Blue line: area of dural sac, Red line: area of nerve root
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